Naawe okyuse oluvannyuma lw’okulumwa ennyo era okumala ebbanga eddene? Ka twogere ku CPTSD (Complex PTSD)!

Ffenna tulina okwolekagana n’ebintu ebizibu era ebiruma bye tuyitamu mu bulamu bwaffe bye tutasobola na kulowooza, nedda? Naye waliwo ebimu ebibaawo ebitaggwa mu lunaku lumu oba bbiri. Batubonyaabonya okumala ebbanga ddene, nga basima mu mitima gyaffe. Leero, tugenda kwogera ku kizibu ky’obwongo ekiyinza okuva mu mbeera ez’ekikangabwa ez’amaanyi ezibadde zigenda mu maaso okumala ebbanga. Kino kiyitibwa CPTSD oba Complex Post-Traumatic Stress Disorder . Oboolyawo kino okiwulirako, oba ggwe kennyini obubonero buno obuwulira. Ka tulabe kye kiri.

CPTSD (Complex PTSD) kye ki? Mu ngeri ennyangu...

Mu ngeri ennyangu, CPTSD mbeera ya bwongo eyinza okukula singa oba ofunye obuvune obutawona okumala ebbanga eddene. Kino kiyinza okuleeta enkyukakyuka ez’amaanyi si mu birowoozo byo byokka naye ne mu nneeyisa yo. Lowooza ku kino, ng’ekiwundu bwe kitwala ekiseera okuwona, n’ebiwundu eby’amaanyi mu nneewulira nabyo bitwala ekiseera okuwona, era oluusi biyinza okuvaako embeera ez’enjawulo ezinakuwaza mu birowoozo.

Waliwo ebikulu ebiwerako ebiddamu ku situleesi ebiyinza okulabibwa mu CPTSD:

• Bulijjo okuwulira okweraliikirira oba okutya (Okweraliikirira): Oyinza okuwulira buli kiseera ng’ekintu ekibi kigenda kubaawo.
• Ebintu ebikuddirira oba ebirooto ebibi: Oyinza okuwulira ng’ekintu ekikuluma ddala kiddamu okubaawo, oba oyinza okuba ng’otera okuloota ebirooto ebibi ebikwatagana nabyo.
• Okwewala ebifo, abantu, n’ebintu ebikwatagana n’ekintu ekikuleetera ekikangabwa: Oyinza obutawulira ng’oyagala kubeerawo oba okugenda mu bifo ebikujjukiza ekintu ekyo.
• Okukaluubirirwa okufuga enneewulira (Heightened emotional responses): Oyinza okwanguyirwa okunyiiga, okutabuka, okweyisa mu ngeri ey’ekimpowooze, era n’okufuuka omusungu olw’ebintu ebitonotono.
• Ebizibu ebitaggwaawo mu kuyimirizaawo enkolagana: Obuzibu okukwatagana n‟abantu, okubasiga, n‟okukola enkolagana.

Teebereza, waliwo omuntu ayitibwa Nilanthi. Okuva mu buto, awaka wabangawo entalo, era kitaawe yatulugunya nnyo nnyina ne ye. Emyaka gyayita bwe giti. Newankubadde Nilanthi kati muto, bulijjo awulira okutya, afuna obuzibu okwesiga abantu, era asunguwala olw’ebintu ebitonotono. Atera okuloota ebintu ebyamutuukako ng’akyali mwana muto. Embeera ey’ekika ekyo eyinza okuba ekyokulabirako kya CPTSD.

Biki ebizibu ebitawona ebiyinza okuleeta CPTSD?

• Okutulugunyizibwa kw’omwana mu mubiri oba mu by’okwegatta okumala ebbanga eddene.
• Obutabanguko mu maka okumala ebbanga eddene.
• Okubeera omukosefu w’okukukusibwa abantu oba mu by’okwegatta.
• Okubeera mu mbeera ey’entalo okumala ebbanga eddene (Olutalo).
• Obutabanguko mu kitundu obutera okubaawo.

Embeera eno si ya bulijjo mu abo bokka abaafuna obuvune obw’amaanyi mu buto, naye era esobola okufuna CPTSD mu bukulu singa bafuna obuvune obw’ekiseera ekiwanvu bwe butyo.

CPTSD emanyiddwa mu by’obujjanjabi?

Eno nsonga nzibu katono. Ne mu bakugu mu by’empisa, waliwo endowooza ez’enjawulo ku oba CPTSD mbeera ya njawulo oba kitundu kya PTSD (Post-Traumatic Stress Disorder).

Lowooza ku kino: Ekitongole ky’ebyobulamu mu nsi yonna (WHO) kituumye CPTSD ng’embeera ey’enjawulo mu kitabo kyakyo ekisembyeyo, `International Classification of Diseases (ICD-11),` mu 2019. Wabula, ekibiina ekigatta abasawo b’emitwe mu Amerika (APA) tekikkiriza CPTSD ng’embeera ey’enjawulo mu kitabo kyakyo ekya `Diagnostic and Statistical Manual of Mental Disorders (DSM-5) . Naye, DSM-5 erimu embeera eyitibwa `dissociative PTSD` nga ekitundu ekitono ekya PTSD, era obubonero bwayo bufaanagana nnyo ne CPTSD.

Abakugu abamu balowooza nti CPTSD, PTSD, ne BPD (Borderline Personality Disorder) byonna biyinza okuba embeera z’obulamu bw’obwongo ezeekuusa ku buvune ku spectrum y’emu. Kwe kugamba, bayinza okuba nga balina akakwate ku bannaabwe mu buzibu bw’obubonero bwabwe.

Kale njawulo ki eriwo wakati wa CPTSD ne PTSD?

Kino kibuuzo abantu bangi kye babuuza. Enjawulo enkulu ze bbanga ly’okusannyalala n’obubonero.

Twalowoozanga nti PTSD eva ku buvune obw’ekiseera ekitono, gamba ng’akabenje oba akatyabaga ak’obutonde. Naye okunoonyereza kuzudde nti abantu abafuna obuvune obw’ekiseera ekiwanvu, obuddiŋŋana, bafuna obubonero obulala ng’oggyeeko PTSD. Obubonero buno obw’enjawulo bwe buzuulibwa CPTSD.

Mu byombi CPTSD ne PTSD, .

• Okuddamu okulaba omukolo (flashbacks), .
• Okubeera obulindaala ennyo (okubeera obulindaala buli kiseera era mu ngeri eteetaagisa ku bintu ebimwetoolodde), .
• Okuddamu ku situleesi mu birowoozo n‟enneeyisa kuyinza okulabibwa, gamba ng‟okwewala ebintu ebikujjukiza ekintu ekizibu ennyo.

Wabula abantu abalina CPTSD nabo bafuna ebizibu ebirala :

• Ebizibu ebitawona era ebibunye wonna mu kulungamya enneewulira: Okunyiiga amangu olw’ebintu ebitonotono, okuwulira ennaku, n’obutasobola kufuga nneewulira.
• Ensonga ezikwata ku ndagamuntu n‟okwewulira: Ebirowoozo ebibi ku ky‟oli n‟omuwendo gwo gwe guli. Okuwulira ensonyi, okwesalira omusango, n’okulemererwa bitera okubaawo.
• Ebizibu mu kukuuma enkolagana: Kizibu nnyo okuzimba n’okukuuma enkolagana ey’amaanyi, ey’amakulu n’abalala.

Njawulo ki eri wakati wa CPTSD ne BPD (Borderline Personality Disorder)?

CPTSD ne BPD zirina obubonero bungi bwe bumu, gamba ng’okweyisa mu ngeri ey’ekimpowooze, okuwulira nti tolina mugaso, n’okukaluubirirwa okukuuma enkolagana ennywevu. Kino kireetedde abakugu abamu okubuusabuusa oba ddala obukwakkulizo buno obubiri bwa njawulo.

Okusinziira ku misingi eriwo kati, enjawulo enkulu eri nti CPTSD yeetaaga obuvune obutawona okusobola okukula. While BPD does not necessarily require a trauma to develop , BPD etera okukwatagana nnyo n‟ebintu ebizibu ebibaawo, gamba ng‟okutulugunyizibwa oba okulagajjalirwa mu buto.

Enjawulo endala eri nti BPD etera okulabika mu myaka emito, naye CPTSD esobola okubaawo ku myaka gyonna.

CPTSD ya bulijjo etya?

Olw’okuba CPTSD mbeera mpya ezuuliddwa, n’okutuusa kati tewannabaawo kunoonyereza kumala ku ngeri gye ya bulijjo. Wabula abakugu bateebereza nti embeera eno eyinza okukosa abantu wakati wa 1% ne 8% ku bantu b’ensi yonna. Kino kitegeeza nti mu Sri Lanka wayinza okubaawo abantu abatawaanyizibwa embeera eno.

Bubonero ki obwa CPTSD?

Okusinziira ku nsengeka y’ekitongole ky’ebyobulamu mu nsi yonna eya `ICD-11`, CPTSD erimu obubonero bungi obukulu obwa PTSD. Ekyo kili:

• Flashbacks: Okuwulira nga ddala ekintu eky’ekikangabwa kiddamu okubaawo.
• Okwewala n‟okwekutula ku bantu, ebibaddewo, n‟ebintu ebizimba obutonde ebyavaako okulumwa.
• Okwegendereza ennyo mbeera ya buli kiseera ey’okubeera obulindaala ennyo olw’okutya akabi.
• Okulowooza ennyo n’enneewulira embi.

Ng’oggyeeko kino, waliwo obubonero obulala obuwerako obw’enjawulo ku CPTSD:

• Okusukkiridde okukola ku nneewulira embi, obusungu, n‟enneeyisa ey‟obusungu (Affective dysregulation): Mu ngeri ennyangu, okunyiiga amangu, okunyiiga, n‟okukaluubirirwa okufuga enneewulira ne ku bintu ebitonotono.
• Okubeera n’endowooza embi ey’okwefaako: Bulijjo okubonaabona olw’okuswala, okwesalira omusango, okuwulira ng’olemereddwa, n’okubeera nga tolina mugaso.
• Obuzibu obw’amaanyi mu kukola n’okukuuma enkolagana ey’amakulu: Kizibu nnyo okwesiga abantu n’okukola enkolagana ey’oku lusegere.

"Nzijukira, nnalina mukwano gwange eyabonaabona ennyo ng'akyali mwana muto. Yali tasobola kwesiga bantu balala. Omuntu ne bwe yamwenya n'ayogera naye, yalowoozanga nti ateekawo omutego. Yalina emikwano mitono nnyo." – Embeera ey’ekika kino esobola okulabibwa mu CPTSD.

Kiki ekivaako CPTSD? Kiki ekituuka ku bwongo bwaffe?

Okusinziira ku ICD-11, CPTSD eva ku kukwatibwa ekintu ekizibu oba ebintu ebiddiriŋŋana eby’engeri ey’obulabe ennyo. Ebintu bino bitera okuwangaala, biddiŋŋana, era nga bizingiramu embeera ng’okutoloka tekusoboka oba n’okuba okw’akabi.

Ebimu ku byokulabirako bye bino:

• Obutabanguko mu maka okumala ebbanga eddene.
• Okutulugunyizibwa mu by’okwegatta oba mu mubiri mu buto.
• Okutulugunya.
• Okwolekedde ekittabantu.
• Okubeera abaddu.

Ekika kino eky’okunyigirizibwa okw’amaanyi, okumala ebbanga eddene kiyinza okuleeta enkyukakyuka mu kemiko n’ensengeka y’obwongo bwo . Okunoonyereza kulaga nti obuvune busobola okuleeta enkyukakyuka ez’olubeerera mu bitundu ebikulu ebiwerako eby’obwongo bwaffe. Ebitundu bino bye bino:

• `Amygdala`: Kino kye kitundu ekikulu eky’obwongo bwaffe ekikola ku kutya n’enneewulira endala. Kiringa akafo akatono akafuga enneewulira zaffe naddala ezo ezitegeera enneewulira ng’okutya. Ekitundu kino kiyinza okufuuka ekisusse olw’okulumwa, y’ensonga lwaki bulijjo tutya era nga tuli bulindaala.
• Hippocampus: Kino kye kitundu ekikulu eky’obwongo bwaffe ekitereka ebijjukizo byaffe n’okutuyamba okuyiga ebintu ebipya. Obuvune busobola okukendeeza ku nkola y’ekitundu kino, y’ensonga lwaki oluusi tufuna obuzibu okujjukira ebibaddewo n’okuyiga ebintu ebipya.
• Prefrontal cortex: Wano we tukolera ebintu bingi ebikulu, gamba ng’okuteekateeka, okusalawo, okulaga omuntu waffe, n’okufuga enneeyisa y’abantu. Obuvune era busobola okukyusa enkola y’ekitundu kino, y’ensonga lwaki kizibu okufuga enneewulira n’okusalawo mu bwangu.

Okunoonyereza okumu ku neuroimaging kulaga nti enkyukakyuka zino zirabika nnyo mu bwongo bw’abantu abalina CPTSD okusinga abo abalina PTSD.

Ozuula otya mu butuufu oba olina CPTSD?

Tewali kukebera kwonna okuzuula CPTSD. Mu kifo ky’ekyo, omusawo oba omukugu mu kubuulirira ku by’obulamu bw’obwongo ajja kukubuuza ku bino wammanga:

• Obubonero bwo.
• Ebyafaayo byo eby’obujjanjabi.
• Ebyafaayo byo eby’obulamu bw’obwongo.
• Engeri gye wafunamu obuvune.

Abasawo bakozesa emisingi mu kitongole ky’ebyobulamu eky’ensi yonna ekya `ICD-11` okuzuula CPTSD. Kyokka, olw’okuba CPTSD mbeera yaakazuulibwa, abasawo abamu bayinza obutagimanya. N’olwekyo, kiyinza okuba ekizibu katono okufuna obulwadde obutongole. Omusawo ayinza n’okukugamba nti olina PTSD mu kifo kya CPTSD. N’olwekyo, bw’oba ​​olina obubonero buno, kikulu nnyo okulaba omukugu mu kubudaabuda abantu ku by’obulamu bw’obwongo alina obumanyirivu mu mulimu guno.

Bujjanjabi ki obw’okujjanjaba CPTSD?

Amawulire amalungi gali nti waliwo obujjanjabi obujjanjaba CPTSD! Obujjanjabi obukulu bwe bwa psychotherapy, oba "talk therapy" nga ffenna bwetukimanyi. Okusingira ddala, ekozesa ekika ky’obujjanjabi obw’enneeyisa obw’okutegeera obuyitibwa trauma-focused CBT .

Obujjanjabi buno buweebwa omukugu mu by’obulamu bw’obwongo omutendeke, alina layisinsi , gamba ng’omukugu mu by’empisa oba omusawo w’eby’omutwe. Obujjanjabi buno buwa obuwagizi, okusomesebwa, n’obulagirizi eri ggwe n’abaagalwa bo okukuyamba okukola obulungi n’okutumbula embeera yo.

Mu CBT etunuulidde Trauma, ebintu bino bibaawo:

• Oyiga ku ngeri omubiri gwo gye gukwatamu obuvune n’okunyigirizibwa.
• Yiga engeri y’okuddukanyaamu obubonero.
• Kiyamba okuzuula endowooza ezirimu obuzibu n’okuzikyusa (reframing).
• Obujjanjabi bw‟okukwatibwa: Abantu abalina PTSD ne CPTSD batera okwewala ebintu oba embeera ezikwatagana n‟obuvune bwabwe. N’ekyavaamu, tebafuna mukisa kuyiga nti basobola okufuga okutya kwabwe ne bwe baba nga bafunye ebizibu ebyo. Mu bujjanjabi bw’okulaga, omusawo akulaga mpola mpola mu mbeera ezikuleetera okutya. Bakutendeka okusigala mu mbeera ezo n’ozitunuulira.

Obujjanjabi obulala obussa essira ku buvune ye Eye Movement Desensitization and Reprocessing (EMDR) . Mu bujjanjabi buno, olowooza ku kintu (ebintu) ekizibu ennyo ng’ossa essira ku maloboozi oba entambula ezenjawulo omujjanjabi z’ayanjula. Ekigendererwa kwe kukendeeza ku bunkenke bw’owulira olw’ebintu ebyo oluvannyuma lw’ekiseera.

Cognitive Processing Therapy (CPT) kika ekirala eky’obujjanjabi obussa essira ku buvune. Obujjanjabi buno bussa essira ku kukola ku birowoozo n‟enneewulira ebikutawaanya era ebitera okuba ebizibu ebijja mu birowoozo byo oluvannyuma lw‟ekintu ekikuluma.

Eddagala eriwonya CPTSD

Mu kiseera kino, tewali ddagala lya njawulo erikkirizibwa ekitongole kya Amerika ekivunaanyizibwa ku by’emmere n’eddagala (FDA) okujjanjaba PTSD oba CPTSD. Wabula abasawo bayinza okuwandiika eddagala nga lino okuyamba okuddukanya obumu ku bubonero bwa CPTSD:

• Eddagala eriweweeza ku kweraliikirira: Nga `Selective Serotonin Reuptake Inhibitors (SSRIs)` oba `Serotonin ne Norepinephrine Reuptake Inhibitors (SNRIs).`
• Eddagala eriweweeza ku kweraliikirira.
• Eddagala ly’otulo.

Eddagala lino liwonya bubonero bwokka, so si kuwonya bulwadde buno ddala. N’olwekyo, obujjanjabi bw’eby’omutwe bwe bujjanjabi obusinga.

Kiki ekitegeeza nti CPTSD?

Olw’okuba CPTSD mbeera empya ezuuliddwa, abanoonyereza ku by’obujjanjabi tebannaba kufuna mukisa kukola kunoonyereza kwa bbanga ddene ku yo.

Bangi, CPTSD eyinza okuba embeera obulamu bwabwe bwonna. Naye teweeraliikiriranga! Ekisinga obulungi nti obubonero bwo busobola okuddukanyizibwa obulungi ng’okozesa obujjanjabi bw’eby’omutwe era bwe kiba kyetaagisa n’okozesa eddagala. Kino kitegeeza nti obujjanjabi buno busobola okukuyamba okubeera mu bulamu obwa bulijjo.

Bw’oba ​​olina CPTSD, weerabirira otya?

Ng’oggyeeko okunoonya obujjanjabi, waliwo ebintu ebiwerako by’osobola okwekolera obulamu bwo obw’omutwe:

• Weenyigira mu dduyiro omutonotono okukendeeza ku situleesi n’okulongoosa embeera yo. Ne bw’otambulako akaseera katono oba ekintu nga yoga kirungi.
• Teekawo ebiruubirirwa ebituufu by’osobola okutuukako. Tosuubira bintu binene omulundi gumu. Beera musanyufu n’obuwanguzi obutonotono.
• Mala ebiseera n’abantu be weesiga. Babuulire ku by’oyitamu n’ebiyinza okukuleetera obubonero.
• Laba ebiseera n’ebifo ebikuleetera okuwulira obulungi era ng’oli mu mirembe, biyingiremu emirundi mingi era ogende mu bifo ebyo.
• Weegatte ku kibiina ekiwagira abo abayise mu buvune. Kikuwa amaanyi okwogera n'abantu abayise mu bintu bye bimu naawe.
• Beera wa kisa eri ggwe kennyini, beera mugumiikiriza. Jjukira nti obubonero tebugenda mu kiro kimu. Zijja mpola mpola.

Ekisinga obukulu kwe kutegeera nti toli wekka. Totya kusaba buyambi.

Ddi lw’osaanidde okulaba omusawo?

Nga ojjanjabwa CPTSD, kikulu nnyo okulaba omusawo wo ne/oba omukugu mu by‟obulamu bw‟obwongo buli kiseera. Singa obubonero bwo bweyongera, tegeeza omusawo amangu ago.

Ddi lw’osaanidde okugenda mu kitongole ekijjanjaba abalwadde ab’amangu (ETU) ?

Bw’oba ​​owulira ng’oyagala okwetuusaako obulabe oba ng’olina ebirowoozo by’okwetta, genda mu kisenge eky’amangu ekikuli okumpi amangu ddala, oba kuba ku nnamba ey’amangu etuukirawo mu Sri Lanka (e.g. 1926 National Mental Health Helpline).

Okusaba obuyambi oluvannyuma lw’ekintu ekizibu ennyo kiyinza okuba ekizibu ennyo. Naye jjukira nti okufuna obujjanjabi bwa CPTSD kyetaagisa nnyo. Ekiseera bwe kigenda kiyitawo, obujjanjabi busobola okukuyamba okuwona. Yogerako n’omusawo wo ku ngeri y’okujjanjaba. Bali wano okukuyamba n'okukuwagira.

N’ekisembayo, ebintu by’olina okujjukira (Obubaka bw’okutwala awaka) .

Kale, twogedde nnyo ku CPTSD leero. Bw’osoma bino, oyinza okuba nga wakitegedde engeri embeera eno ey’obwongo gy’eri ey’amaanyi era enzibu.

• CPTSD bunkenke mu birowoozo obuva ku buvune obw’amaanyi obumala ebbanga eddene.
• Ng’oggyeeko PTSD, kino era kireeta obuzibu mu kulungamya enneewulira, okwetwala ng’omuntu, n’okukuuma enkolagana.
• Embeera eno eyinza okuba enzibu katono okutegeera, naye omukugu alina obumanyirivu asobola okugikola.
• Ekisinga obulungi kiri nti embeera eno esobola okuddukanyizibwa obulungi n’obujjanjabi bw’eby’omwoyo (naddala Trauma-focused CBT, EMDR, CPT) era bwe kiba kyetaagisa, n’eddagala.
• Bw’oba ​​olina obubonero buno, tobonaabona wekka era mazima ddala funa amagezi g’abasawo. Okusaba obuyambi si kabonero ka bunafu, kye kimu ku maanyi amanene g’osobola okuba nakwo ku ggwe kennyini.

Jjukira nti wadde nga tosobola kufuga byaliwo mu biseera byo eby’emabega, osobola okukola eddaala leero okulongoosa ebiseera byo eby’omu maaso. Mbaagaliza amaanyi okukikola!

` CPTSD, obuzibu obw’okunyigirizibwa oluvannyuma lw’okukosebwa, obulamu bw’obwongo, okulumwa, situleesi, obujjanjabi bw’eby’omwoyo, PTSD